類風濕性關節炎病患之顳顎關節病變

1. 類風濕性關節炎病患之顳顎關節病變

2. Temporomandibular joint disorders in patients with rheumatoid arthritis • Involvement of temporomandibular joint (TMJ) by rheumatoid arthritis (RA) is common with a reported incidence varying from 5 to 88 %. However, the extent of involvement and its clinical relevance still have not been well- characterized. In the clinical ground, a selection of the RA patients with degree of TMJ problems mandating proper transfer and prompt treatment is essential. In this study, fifty-six randomly sampled RA patients were en- rolled and their histories were reviewed. TMJ problems were surveyed clini- cally by detailed questionnaire and physical examination and radiologically by tomography. The patients with TMJ involvement were further categorized into mild or severe group to allow factor comparison and risk analysis. Clinical and radiological TMJ abnormalities were found to be highly pre- valent (85.5% & 74.6%) in these patients, and the intensity of abnormalities were correlated variably with disease severity indices of RA. Half of the patients belonged to a subset presenting with discernible symptoms or radio- logical involvements to a greater extent. After multivariant analysis, the severity of hand joint destruction was found to be the best predictor of such cases. This may provide a convenient and useful tool for rheumatologist to early identify RA patients with risk of severe TMJ abnormalities. It is hopeful the occurrence of chronic disabilities or long term complications associated with this problem may be reduced by this way.